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J Am Med Dir Assoc. 2017 May 1;18(5):453.e1-453.e6. doi: 10.1016/j.jamda.2017.01.024. Epub 2017 Mar 18.

Epidemiology of Pain in People With Dementia Living in Care Homes: Longitudinal Course, Prevalence, and Treatment Implications.

Author information

1
Department of Old Age Psychiatry, Institute of Psychiatry, Psychology, and Neuroscience, King's College London, London, United Kingdom; Mental Health of Older Adults and Dementia Clinical Academic Group, South London and Maudsley NHS foundation Trust, London, United Kingdom.
2
University of Exeter Medical School, University of Exeter, St Luke's Campus, Exeter, United Kingdom.
3
Psychological Services, Oxford Health NHS Foundation Trust, Fulbrook Center, Oxford, United Kingdom.
4
Institute of Mental Health, Faculty of Medicine and Health Sciences, University of Nottingham, Nottingham, United Kingdom.
5
Institute of Rehabilitation, Dementia Applied Research Center, University of Hull, Hull, United Kingdom.
6
Dementia Services Development Center, Wales, Institute of Medical and Social Care Research, Bangor University, Bangor, United Kingdom.
7
Section of Mental Health and Aging, Health Service and Population Research Department, Institute of Psychiatry, Psychology, and Neuroscience, King's College London, London, United Kingdom.
8
Whitaker Research Ltd, Bangor, United Kingdom.
9
Psychological Services, Oxford Health NHS Foundation Trust, The Fulbrook Center, Oxford, United Kingdom.
10
London School of Economics and Political Science, London, United Kingdom.
11
Alzheimer Society, Devon House, London, United Kingdom.
12
Wolfson Center for Age-Related Diseases, King's College London, London, United Kingdom.
13
Center for Age-Related Medicine, Stavanger University Hospital, Stavanger, Norway.
14
University of Exeter Medical School, University of Exeter, St Luke's Campus, Exeter, United Kingdom. Electronic address: a.m.j.corbett@exeter.ac.uk.

Abstract

INTRODUCTION:

Knowledge regarding the longitudinal course, impact, or treatment implications of pain in people with dementia living in care homes is very limited.

METHODS:

We investigated the people with dementia living in 67 care homes in London and Buckinghamshire, United Kingdom. Pain, dementia severity, neuropsychiatric symptoms, depression, agitation, and quality-of-life were measured using appropriate instruments at baseline (N = 967) and after 9 months (n = 629).

RESULTS:

Baseline prevalence of pain was 35.3% (95% CI 32.3-38.3). Pain severity was significantly correlated with dementia severity, neuropsychiatric symptoms, depression, agitation, and quality of life at both time points. Regular treatment with analgesics significantly reduced pain severity. Pain was significantly associated with more antipsychotic prescriptions. Pain was significantly associated (OR 1.48; 95% CI 1.18-1.85) with all-cause mortality during follow-up.

CONCLUSIONS:

Pain is an important determinant of neuropsychiatric symptoms, mortality, quality-of-life, and antipsychotic prescriptions. Improved identification, monitoring, and treatment of pain are urgent priorities to improve the health and quality-of-life for people with dementia.

KEYWORDS:

Pain; analgesics; dementia; depression; mortality; quality of life

PMID:
28330634
DOI:
10.1016/j.jamda.2017.01.024
[Indexed for MEDLINE]

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